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Kate Miller talks to the experts about the prevalence of urinary tract infections, old wives’ tales which lead to common misconceptions, and the new smartphone-powered technology which could represent the future of urinalysis

There can be few women who haven’t experienced the familiar tingle of the beginnings of a urinary tract infection (UTI) – and have probably taken some antibiotics and dismissed the experience as part and parcel of being female. While men can, and do, get UTIs, the quirks of biology make it more prevalent in women.

According to the World Health Organization, over 50% of women report having had a UTI at some point in their lives, and factors such as the decrease in oestrogen, loss of Lactobacilli in vaginal flora, pelvic organ prolapse and increased E. coli colonization of the tissues surrounding the urethra make it more prevalent post-menopause. In fact, for older women the problem can become a real issue. “Many women suffer with recurrent UTIs that can continue for years at a time,” says nutritionist Shona Wilkinson.

The most loyal and grateful customers, according to Dr Gras Balguer, technical director of Vita Green Europa, are ‘older ladies who first encountered, to their surprise, a problem with frequent UTIs after the menopause. “This group is more likely to report recurrence and issues with antibiotic resistance … About 20% of women that suffer a UTI go on to suffer recurring problems, with three or more episodes a year.”

A study by UT Southwestern Medical Centre in the US, published in the Journal of Molecular Biology, looked into the prevalence of UTIs in postmenopausal women. It found that in recurrent UTI (RUTI) patients, several species of bacteria can work their way deeper into the bladder’s surface area, with bacterial diversity, antibiotic resistance and the adaptive immune response all playing roles in the development of the condition. According to one of the authors of the study, Professor of Molecular Biology and Biochemistry, Dr Kim Orth, the finding points to the need for new ways to treat the condition. “We will need to use methods other than antibiotics to treat this disease, as now we observe diverse types of bacteria in the bladder wall of these patients.” The significance of this study was that it involved older women where reoccurrence is more prevalent, whereas the outcome of previous studies focused on a younger age group.

Separating truth from fiction
However prevalent the condition is, there is still a lot of misinformation in the public domain. Wilkinson blames old wives’ tales and internet information for the confusion: “I have even been told they thought they got it by sitting on a radiator!” This is worrying because, left untreated, a UTI can be serious business: “It’s important to stress that any UTI should be checked out by your doctor, as it could lead to a kidney infection and scarring – permanently damaging kidney function.” And obviously, as with any infection, there is always the chance of sepsis.

As mentioned by Orth, the main treatment is antibiotics. But, for RUTIs this brings with it the danger of antibiotic resistance, and all the other miseries that come from persistent antibiotic use. Therefore, the key must be in prevention, which is where our industry steps in.

Just for Tummies founder Linda Booth says that in 27 years as a natural health practitioner, she’s seen a huge lack of both education and awareness when it comes to preventing, managing and reducing UTIs.
“The feeling is that nothing can be done about it, other than take the antibiotics every time they get a UTI. I’m not just talking about women … GPs too, who don’t seem able to look ‘outside the box’ and recommend probiotics as a preventative.

“About 20% of women that suffer a UTI go on to suffer recurring problems, with three or more episodes a year”

Common triggers
“I’ve spoken to thousands of women who suffer with UTIs, and I always ask the same question: “Was there a time when you didn’t suffer with a UTI, and what happened to trigger it?” It’s usually taking broad-spec antibiotics for another infection, which doesn’t just kill the bacteria causing an infection – chest, throat, skin, bowel etc – but also decimates the commensal bacteria in the bladder, bowel, skin and lungs.”

Booth says education around the benefits of taking strain-specific probiotics containing Lacto reuteri is key. Her For Women probiotics contain three billion bacteria per capsule with strains of Lacto acidophilus, Lacto rhamnosus and Lacto reuteri. “I decided to put in Lacto rhamnosus because it’s also a very effective strain at reducing IBS type symptoms, especially uncomfortable bloating, so you could say that For Women is a 2-in-1 to help reduce UTIs and IBS.”

Balguer points out a temptation among women to glug cranberry juice as a natural alternative to antibiotics – but, as it contains lots of sugar, which is one of the factors that can affect UTIs, this isn’t recommended. Vita Green’s Cysticlean product, aimed at prevention, contains a high dose (240mg) of proanthocyanidins (PACs), an antioxidant found in cranberries. Studies show that PACs have an ability to block the receptors existing on the bladder walls, improving the bladder’s ability to flush away toxins. In studies, a higher concentration of PACs has been proven to have a greater effect.

“Sugar just loves to wipe out healthy gut bacteria, and when the gut tips in favour of bad bacteria it can lead to a whole host of problems, including increasing your likelihood of infection,” says Wilkinson. “Unfortunately, alcohol contains high levels of sugar, which only feeds that pain-causing bacteria. It has also been found that those who drink more than three cups of coffee per day have an increased risk of experiencing bladder issues.”

As well as a cranberry extract, she recommends D mannose. “It has tiny fingers which are coated in lectin. D mannose binds to the lectin and makes the E. coli fingers unable to adhere to the urinary tract wall, allowing them to be washed out with urine flow.”

In the prebiotics and probiotics category, Wilkinson recommends taking a daily supplement containing at least one billion live cultures including L. acidophilus, Bifidobacteria and Lactobacillus strains. “Prebiotics should be included in the diet and can be found in many foods such as sauerkraut, kimchi, chicory, garlic, leek, onion, dandelion and Jerusalem artichokes.”

Last, but not least, she advises that customers take at least 500mg of vitamin Ca day and get tested for vitamin D: “Vitamin D is needed for the normal function of the immune system and our ability to fight off infection. Most of the UK population is vitamin D deficient, however vitamin D does get stored in the body so a vitamin D test is always advisable.”

Dipping inWith an ageing population, the prevalence of UTIs is likely to get worse. Early diagnosis can mean better treatment and less long-term damage.

Unfortunately, according to figures from NHS Digital, only two out of five GP appointments take place on the day they are booked – and one in five patients waits two weeks for a GP appointment.

Therefore, the development of a pilot NHS scheme of fast-track UTI testing and treatment – without the need to see a GP – could be a significant breakthrough. It is currently being trialled in 38 Pharmacy First branches across Nottinghamshire and Derbyshire. Instead of
waiting for a GP appointment, women will be offered a home-use kit developed by Healthy.io, the creator of next generation smartphone-powered urinalysis. Pharmacist and advisor to Healthy.io, Sid Dajani, says of the initiative: “If only one in ten women with a UTI was treated in a pharmacy instead of their GP, the NHS would save £28 million a year in England alone, and there would be millions more appointments available for more serious or urgent problems.”

New beginningsA few years ago it would have been inconceivable that a male Hollywood actor would be the face behind a campaign to encourage dads to speak openly about periods with their daughters in a bid to destigmatize them. Yet here we are with Michael Sheen standing in front of an aisle of sanitary products, talking about Pads4Dads.

Similarly, the idea of BBC Breakfast running an entire week of programmes about the menopause – uttering phrases like ‘vaginal dryness’ with abandon – would have been enough to make viewers choke on their cereal.

But times are a-changing, and the coyness and whispering which has traditionally greeted the nitty gritty of female biology is beginning to fade.

In this context of more openness, a new website has entered the fray to
provide information and a shopping portal for female health, focused on the menopause but aimed at evolving to support women ‘from their first period to way past their last’.

Founded by Gervase Fay and Kate Bache, Health & Her looks at both the physical and psychological impact of the menopause, covers the ‘30 symptoms of the menopause’ and aims to provide unbiased information and expert advice.

Products sold on the site include brands such as Pukka Herbs, A. Vogel and Salt of the Earth, as well items like acupuncture mats. It also includes a symptom tool with tailored advice and recommended products.

Hot Stocks

Femme-friendly Offering nutritional support to women going through the hormonal changes of menopause, Femaralle Recharge contains a combination of vitamins B2, B7 and D3, fermented soya extract and ground linseed to help maintain balance. Femaralle Unstoppable is aimed at post-menopausal women, and designed to contribute to prolonged bone and vaginal health, joint and muscle flexibility, better sleep and increased energy levels.

Flower powerHarnessing the power of nature, Woman Oral Spray from Australian Bush Flower Essences ‘harmonizes any emotional imbalances’ experienced during menstruation and menopause. Two sprays directly onto the tongue can help users alleviate and cope with mood swings, weariness and change. The blend contains essences of ten flowers, purified water and brandy, which acts as a natural preservative.

Australian Bush Flower Essences Woman Drops

The award-winning Australian Bush Flower Essences Woman Drops, together with Woman Oral spray, Mist & Cream can help to harmonise imbalances during menstruation and the menopause. They are most commonly used to help overcome mood swings, feelings of weariness and to deliver a feel-good emotion about oneself, their body and beauty. The go-to brand of life balancing remedies for your everyday needs. The ABFE range is ethically sourced from pristine bush-land environments by founder, Ian White, a fifth-generation Australian herbalist and naturopath. ABFE are meeting the growing demand for emotional nutrition products that help to bring life back into balance.

Carefully formulated to eliminate excess water

FSC Waterfall is a carefully formulated blend of herbal supplements, including Dandelion Extract, Green Tea and Cider Vinegar to naturally help eliminate excess water and bloating.

All FSC supplements are made in the UK with the finest ingredients and based on widely recognised scientific evidence of their health qualities.FSC Waterfall is suitable for Vegetarians and it is recommended to take one tablet in the morning, preferably with food.

Menovital

Take the misery out of menopause
One the most challenging stages of a woman’s life is the menopause, levels of female hormones, oestrogen and progesterone begin to fall during this time. This can cause unpleasant symptoms such as hot flushes, night sweats, irritability, mood swings and depression. MenoVital® is one of the most comprehensive Menopause products on the market. It consists of: 16 essential ingredients including: Soy Isoflavones, Flaxseed, Siberian Ginseng extract and Starflower to help the body maintain overall health and well being during the mid life change. MenoVital from HealthAid retails at £11.99 for 60 tablets. Contact HealthAid Ltd on020 8426 3400 for purchase and stockist information or visit www.healthaid.co.uk

Everyday BioAcidophilus

We are all unique but many of us share a common challenge – hectic lives. Our environment, fatigue, diets and general pressures all play a part. Everyday BioAcidophilus is designed to help our bodies cope with the demand.

For Women probiotic capsules

The incentive to develop my For Women capsules came out of a visit to my clinic by a woman needing help with her chronic constipation.I have met and treated tens of thousands of people over the years, but this visit struck a chord.This woman had developed antibiotic resistance after taking multiple courses of broad-spectrum antibiotics for decades of recurring UTIs. The antibiotics had disrupted the balance of her gut flora and caused her constipation.I decided that I needed to do something to help her, and the many other women struggling with UTIs, by developing a probiotic supplement that would help reduce UTIs, and thus reduce the number of antibiotics women have to take.

Garden of Life Microbiome Formula Once Daily Women’s

A unique ‘one capsule a day’ shelf stable live form of bacteria specifically designed to support a healthy female microbiome. Featuring 16 diverse strains of bacteria, including two particular strains, L.reuteri and L.fermentum, which were chosen for their clinical benefits in supporting women’s health. The strains of bacteria are resistant to both stomach and bile acid, as well as antibiotics. Contains organic acacia and organic potato starch as prebiotics, thus avoiding the commonly used prebiotic fructo-oligosaccharides to minimise bloating and provide better overall digestive comfort. Suitable for those following a Low FODMAP diet. Dairy free, gluten free and soya free.

Nature’s AnswerUT Answer

Modern science has discovered that D-Mannose acts as a ‘decoy’, attracting microbes away from the bladder wall, while cranberry decreases microbe’s ability to adhere to the bladder wall and urinary tract lining. Cranberry has been used by traditional herbalists for centuries to help relieve urinary tract discomfort. Together, they act as a “dynamic duo” to support urinary tract health. Nature’s AnswerUT Answer delivers D-Mannose along with super concentrated cranberry, in a delicious fast acting liquid formula, further enhanced with Quik-Sorb, a blend of ginger rhizome, amla fruit, capsicum fruit, for maximum absorption. Holistically balanced, each ingredient’s botanical footprint is identified for authenticity. Gluten free and vegan.

Wellwoman Vegan

Wellwoman introduces the UK’s first ever comprehensive vegan supplement for women. The specially developed multivitamin provides a unique blend of 23 nutrients to help safeguard dietary requirements for those following a vegetarian and vegan diet, including vitamins B12, C and D. It also contains higher levels of iron plus vitamin B6 and pantothenic acid which help reduce tiredness and fatigue.

Lunette Menstrual Cup

Lunette is revolutionising the future of period care with their small but mighty menstrual cup.

Lunette is a Finnish, women-lead company with a mission and one of the original menstrual cup creators. Their Menstrual Cups come in different colors and are vegan and bpa-free. In addition to being easy to use and giving you up to 12 hours worry-free use, everything Lunette does is sustainable, ethical and taboo-busting.

Every time someone chooses Lunette they are supporting period positivity and locally-driven, impactful women’s rights movements all over the world.

Nascent Iodine – Good Health Naturally

NASCENT IODINE is the most ideal form of iodine, rapidly absorbed and utilised by the body when taken as a nutritional supplement.This vital mineral plays an essential role in the normal function of the thyroid gland, optimising energy levels, boosting the immune system and may potentially prevent fibrocystic breast disease and hypothyroidism. For maximum benefit, Nascent Iodine is best taken alongside Good Health Naturally Ionic Selenium. Ionic Selenium acts as a co-factor to help the body to utilise the Iodine ensuring maximum support for immune health and normal thyroid function.For more information, please visitwww.WholesaleHealthLtd.co.uk or call us on 01606 889905.

Bio-Kult Pro-Cyan and Bio-Kult Candéa

Bio-Kult Pro-Cyan is an advanced triple action formulation containing cranberry extract and two specifically selected strains of live bacteria. Pro-Cyan also contains vitamin A, which contributes to the normal function of the immune system and the maintenance of mucous membranes which can be found lining the urinary tract. Bio-Kult Candéa is a scientifically developed multi-action formulation with seven strains of live bacterial alongside garlic and grapefruit extract both of which are well known for their naturally powerful properties. Bio-Kult bacteria strains have been proven to survive high stomach acidity, do not need to be refrigerated and are suitable for vegetarians.

Alive! Women’s Energy Ultra Wholefood Plus

Alive! Women’s Energy Ultra Wholefood Plus multivitamins contain 26 essential vitamins and minerals to support normal energy, immunity, bones, fertility and hair and skin. Packed full of additional botanicals it also contains cranberry extract and a bespoke Beauty Blend featuring Grapeseed extract. A unique daily greens blend of 13 botanicals, including spirulina and kelp, Flax Lignans and a Digestive Enzyme blend are also included in this high-strength multivitamin solution. And as with all Alive! products it also contains a blend of 26 whole fruit and vegetable powders. Suitable for vegetarians. RRP £24.99 for a 2 month supply (60 one-a-day tablets).

Cysticlean 240mg PAC®

Cysticlean – containing 240mg PAC’s derived from the North American Cranberries, has one of the highest levels of PAC’s available.A million women in Europe have benefited from natural Cysticlean 240mg PAC®. Drug free support from experts in the maintenance of the urinary system. Healthcare professionals may access clinical studies at www.cysticlean.co.uk
Major wholesalers list Cysticlean 240mg PAC® – CLF, Tree of Life, The Health Store, Jumla Nutrition & Bodycare and Lexon.
Training & training materials available via email address [email protected]@cysticlean.com

Silica Complete For Optimal Skin, Hair and Nail Health

One tablet provides 200mg of silica. We use naturally derived silica from bamboo gum which contains 75% organic silica and is one of the richest, most bioavailable forms. MSM (Methylsulphonylmethane), a natural sulphur containing compound, has been included as it’s an essential nutrient required for the body’s production of proteins, many of which are found in hair, skin and nails. We’ve also added:

• Biotin as it contributes to the maintenance of normal hair and skin
• Zinc as it contributes to the maintenance of normal skin, hair and nails
• Vitamin C as it contributes to the maintenance of normal collagen production.

OrganiCup – the menstrual cup (Size A, B and Mini)

The Danish sustainable menstrual cup brand OrganiCup is the healthier, easier and greener alternative to pads and tampons. OrganiCup is reusable for years, it provides up to 12 hours of freedom during the day and night and it doesn’t contain any harmful chemicals. OrganiCup is made from pure medical grade silicone, is FDA approved, registered with The Vegan Society, and, as the only menstrual cup on the market, certified hypoallergenic with AllergyCertified. Recently, the OrganiCup Mini was launched. Mini is made for teenagers and those who need a smaller size. In addition, the range offers OrganiWash and OrganiWipes. Both are cleaning products made from organic and natural ingredients and without perfume.

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